As COVID Ebbs, TB Deaths Must Become Visible: Global Issues

Tuberculosis has killed 1.5 million people in 2020, mainly in African and Asian countries, while two million people died of COVID-19 worldwide during the same period. Credit: Athar Parvaiz/IPS
  • Opinion by Angelique Luabeya – The best of Angelique Luabeya (Cape Town, South Africa)
  • Inter Press Service

As we emerge from the devastating toll of the pandemic on people’s lives and global economies, we must wake up to the staggering 1.5 million TB deaths and 10 million new infections recorded in 2020. And these deaths occurred mainly in Africa and Asia. countries.

These deaths were largely invisible as we battled COVID-19. Even as countries lift COVID-19 restrictions due to declining numbers, we know that TB continues to spread.

Access to tuberculosis care was also hampered by pandemic restrictions and the prioritization of COVID-19 in diagnosis and care in health facilities. The World Health Organization (WHO) goal is to reduce new TB cases by 90% and TB deaths by 95% by 2035. We have 13 years left to reach that milestone.

The harsh reality is that we still do not have a protective vaccine and cases of drug-resistant tuberculosis are on the rise. While research is ongoing, a critical factor hindering progress is lack of funding. The only available tuberculosis vaccine, Bacille Calmette-Guérin (BCG), developed in 1920, has limited efficacy.

The relatively rapid availability of various vaccines, treatments, and diagnostics for COVID-19 illustrates how billions of dollars in funding can accelerate the development of vaccines against a deadly new disease. For example, the funding available for the development of the COVID-19 vaccine is estimated at US$107 billion, while only US$0.117 billion is available for tuberculosis.

However, tuberculosis has killed 1.5 million people in 2020, mainly in African and Asian countries, while two million people died of COVID-19 worldwide during the same period. To date, there are 109 vaccine candidates for COVID-19 and only 14 for TB. As noted, we only have one vaccine against tuberculosis, while there is 18 vaccines available for COVID 19 .

Tuberculosis research needs at least $15 billion to have a chance of reaching the 2035 target. At the moment, researchers have access to only half this amount.

Why is there a lack of funding for a deadly, centuries-old disease?

It can be argued that tuberculosis research is too expensive. We have several phases to test new drugs or vaccines in clinical trials. Before being tested in humans, new drugs and vaccines are tested in animals to determine safety and proper immune response. Then there are at least four phases of testing in clinical trials. The next cost implication is that there are several strains of the TB bacteria that increase testing costs.

Tuberculosis is a chronic disease with slow progression from infection to disease. Measuring vaccine effectiveness requires resources, time, and a large sample size of people participating in these studies. These steps add to the complexity and cost of TB vaccine development. But these costs are small compared to what we spend on COVID-19 research.

Could the reluctance to finance stem from the fact that the burden of TB falls heavily on poor countries in the global South? Tuberculosis is not a pandemic, so the global urgency to find a vaccine or medicine is different.

Pharmaceutical companies often invest in drugs and vaccines from which they can make a profit. Therefore, rich countries have other health priorities. While rich countries have been affected by COVID-19, tuberculosis is largely controlled there.

Unfortunately, the majority of people at risk for tuberculosis come from low- and middle-income countries that cannot afford vaccines or expensive drugs. The incentive for these big pharmaceutical companies to invest in developing tuberculosis vaccines is low.

In the 2016 report “The catalytic framework to end AIDS, tuberculosis and malaria in Africa by 2030”, the African Union (AU) itself noted that “funding for research and innovation is not a priority in the AU members, intra-African cooperation lags behind”. and partnerships are still largely established outside of Africa.” While external funding is critical, African countries need to strengthen and rethink strategies to accelerate the development of TB vaccines and drugs.

As we launch COVID-19 vaccines and ARVs become available to HIV patients, we must renew our efforts to do the same for TB. Tuberculosis carries a high cost of infection, treatment and death. It is the biggest cause of death for HIV patients.

African and Asian countries should invest in vaccine research and drug development because they bear the heaviest burden. In addition, they must strengthen weak health systems and bolster efforts to properly identify and treat TB cases to stop transmissions.

The HIV and COVID-19 pandemics have shown that money can be released when humanity is threatened. The rapid spread of SARS-CoV2 illustrates the fact that the modern world is a global village.

The world must wake up to the rise in microbial resistance including tuberculosis Drug-resistant tuberculosis is a real threat to humanity.

We must not wait for a COVID-like crisis to act. We need to harness the partnerships of this pandemic to prevent another. A world without tuberculosis feels like a dream. An effective vaccine can make it happen.

Dr. Angelique Luabeya Kany Kany is the Research Director of the South African Tuberculosis Vaccine Initiative, University of Cape Town. Dr. Luabeya is the principal investigator for several novel TB vaccine clinical trials, two COVID-19 vaccine trials, and diagnostic studies. She is a WHO-TDR Clinical Research and Development Fellow.

© Inter Press Service (2022) — All rights reservedOriginal source: Inter Press Service

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